The stakeholders in this scenario are all the individuals who can influence or be influenced by the system in which the provision of health is carried out. The major stakeholders in this particular situation are the patients, the physicians, both employed and the owners, the clinical staff, the non-clinical front office staff, and the government (St Joseph’s University, 2011). The patient is the primary beneficiary and the lea stakeholder of the healthcare system. The services are centred around them, and they, therefore, dictate, to some extent, the type of services that are provided to them. Their principal responsibility is to ensure that they have a hand in controlling their health and the costs that come with it. By doing so, they are mandated to care for themselves by living a healthy lifestyle, and by doing so, they can spend fewer costs on seeking treatment and medication. The patient is in a position to dictate the type of treatment that they prefer, provided they are knowledgeable about the procedures and are in their right state of mind.
The physicians are the second stakeholders within the health care system. They are responsible and have an ethical responsibility for safeguarding the rights of the patient. This is exercised by providing the necessary treatments to the patient, in line with the medical diagnosis that they have made. They are also mandated to refer the patient to another physician if they lack the necessary treatments or expertise in dealing with the unique cases of the patient.The clinical staff is the third in the hierarchy of the stakeholders. These consist of nurses and medical assistants. This also includes the professionals who work in the laboratories and other sectors of the medical field. The clinical staff acts as the advocate for the patient, together with the physicians as they work, to ensure that the patients can access adequate and efficient health care services. The nurses work to ensure that the patients receive timely treatments and that they are catered to during the time that they are admitted in the health facility. The medical assistants also serve the patients and ensure that their rights are protected, in line with the services that they provide.
The non-clinical front office staff is also stakeholders in this scenario as they stand to be affected and may influence an effect within the health facility. This consists of the administration team, the human resource team, and the attendants who are at the front desk of the facility. These individuals handle the patient before they get to be attended to by the doctor or any other medical personnel. They are responsible for the information given to them by the patient immediately they come through the door. Their responsibility is to attend to the patient quickly and be in a position to process their information and hand them over to the respective medical personnel.
Finally, the government forms an integral part of the healthcare system. Their responsibility is to provide equal healthcare to all individuals and to ensure that these patients have a right to liberty. The government in this scenario is the payer as they are responsible for the procurement and provision of healthcare within each country or state. In addition to this, they subsidize the cost to healthcare, especially for the vulnerable groups, which are the elderly, the less fortunate, and the disabled.
Impacts of the Acquisition
The acquisition of the 25-physician multispecialty practice would affect the patient significantly. Through the improvement of the preadmission, post-discharge procedures, and service delivery, the care of the patients is also improved. The more the physicians who can attend to the patients, especially in the preliminary stages of treatment, the better the quality of care that is administered to them. An increased number of physicians means that the availability of the physicians is spread out, and they are in a better position to adequately attend to all their patients. The workload is reduced, and therefore, the health outcomes turn out to be more positive.The physicians, who are also stakeholders, are impacted positively, as they can carry out their duties efficiently as they have more time on their hands due to the influx of additional personnel. They have a reduced workload and less pressure to attend to patients, which may be inadequate. Therefore, they can carry out their duties, in a more peaceful environment. This has a positive impact on their wellbeing and mental wellness.
The nurses and medical assistants can tend to their patients better as they are equipped with more knowledge as to the care that is needed to the patients. This care is usually instructed and given by physicians. They are also able to offer better quality care during the admission period and the discharge period as they work in close collaboration with the physicians to provide the best care. They are also in a better position to learn and acquire skills that will benefit their practice, as they can work in a better environment that is more peaceful and closely-knit. The other clinical staff, such as the medical assistants stand to benefit in the same way as the nurses.
For the non-clinical front office staff, their work is made more accessible. Through the admission process, they can know that the physicians are available, therefore making the admission process much faster and smoother. If more physicians are available during the admission process, the staff can know how to serve the patients better. This goes for the post-discharge process as well.
The government is impacted in many ways, as they have to provide additional funds to pay the new physicians within the health facility. It will have to cough up more money to give the new staff with benefits and other materials that will enable them to work. Also, the government, with the arm of the ministry of health, will have to come up with more policies that will address the new procedures of the preadmission and post-discharge process. New policies will have to be put in place to ensure that there are no loopholes or discrepancies that will be of maleficence to the patient.
Barriers for Change
Inability to source funds for the additional staff would be a significant barrier as the government may be unable to budget for the extra salaries that are required to pay the physicians. This would have to attribute to the fact that the ministry of health may have projects that they need to fund, and therefore, the funds that are required to pay the physicians may be held up in other ongoing projects. Another barrier to change would be the conflict that is faced within the workplace. The political environment and the dynamics may be altered with the acquisition of the new personnel. The physicians who were previously employed may feel that the newly hired have come to take over their jobs, and therefore, a hostility is formed. This hostility leads to the slow pace of the workplace and an inability to embrace change, which is evident in the service delivery.
Finally, another barrier to change would be the hardship to adjust to the new environment and a new system of working. With a new procedure in the preadmission and post-discharge process, it may be challenging to adapt and to get familiar with the latest running of systems. This may lead to slow services and in some instances, poor services.
The criteria I would use to prioritize these barriers would be the urgency that each barrier poses. The seriousness of the matter would dictate how I would tackle these barriers. If one barrier represents a significant effect on the facility, and how it runs, I would attend to this barrier first, as compared to the rest of the obstacles. If they are likely to cause damage or hurt the patient, I would also deal with this barrier first and prioritize it.
As urgency is the important criteria that I would consider in dealing with the barriers, I would address the issue of the lack of funds first. If the government is unable to provide the funds to pay the new physicians, I will seek other alternatives. The next barrier in order of urgency would be to solve the issue of adjusting to the new system. I would hold a conference where I would invite all the stakeholders and inform them of their roles, responsibilities, and how the new system operates. Finally, I would solve the ongoing political and hostility among the new and old physicians. I would encourage them to work together and inform them that they are there to serve the patients to the best of their ability.
The first leverage point I would use would be to come up with a policy that would reward the employee of the month. This would encourage employees to work hard, and at the end of the month, be rewarded for their excellent work. Another leverage point would be to set a target for the employees, in the form of an appraisal. This would act as leverage to encourage them to set their goals and get rewarded for attaining them. Finally, I would establish ground rules and regulations, which if crossed, would lead to consequences such as salary deductions.
The first proposed strategy would be to exercise authority. The objective of this strategy would be to reduce the level of opposition from the employees and to get them to adhere to the new system of working, the standards that have been set and the norms that have been put in place, in a short period. When authority is exercised, then the employees feel the urge to fall in line and adhere to the new system. This is a coercive strategy that is one of the fastest means to effect change. One must always be present and attentive to the actions of the employees for them to feel that they are under an absolute pressure to work and produce the required results. Regular checks and compliance tests must be carried out to ensure that the employees work and adhere to the recommended practices (Business Enterprise Mapping, 2017).
Another strategy would be to propose specific incentives. This will act as a source of motivation to the employees and encourage engagement in the activities of the facility and is in line with the new direction that it is heading. Also, recognition programs will be put in place to recognize the workers who work hard to ensure quality service delivery and patient satisfaction. They will be rewarded according to their actions, and this will enable them to work harder. The incentives will reinforce the actions of the employees and enforce positive behaviors. Finally, it shows that the management appreciates the efforts and dedication of the employees in trying to adhere to the new system and transition into it.
The strength of exercising authority enables employees to adhere to the standards that have been set by the manager and to work according to the new system that has been put in place. It is a firm hand in the management of employees and therefore, communicates the message of “my way or the highway.” It decreases the opposition from the employees and somehow threatens them to adapt and adhere to the new system of working. In addition to this, it is an effective way of strategy as it yields results quickly, and therefore, the implementation process is faster and swifter.
In providing incentives to the employees, motivation is harnessed. When employees are encouraged and motivated to work, they do so in an effective manner. This strategy has its strength as it enables employees to accept the transition process, embrace it, and follow the employer and the vision that they may have. In addition to this, it changes the attitudes of the employees. When presented with an incentive, the negative attitude goes out the door, and it is replaced with a much more positive one. Their views about the facility also change they work better and more efficiently. It is seen as a sign of appreciation from the upper management and this, in turn, fosters a positive working relationship between the two parties.
The weakness or limitation of exercising authority is that it may lead to the fostering of negative emotions, especially towards the manager. As the manager coerces the employee, the employee may feel that their rights or freedom are being infringed. This may lead to the disintegration of a relationship that was once positive, to one that is negative. It is a strategy that is known to breed resentment often, and this reduces the positive environment that a health facility is supposed to have. Also, it may lead to opposition and conflict either among the employees or between the manager and the employees. This may prove to be a significant problem shortly.
The weakness of the provision of incentives lies in the sense of entitlement that may be fostered among the employees. When employees get accustomed to a particular privilege or honor, they get entitled and expect to be rewarded for doing their jobs. This often manifests itself in scheming and performing one’s duties just for a show and in a bid to get recognized. They then fail to realize that this was just a motivator, and they begin to set the needs of the patient aside and focus on doing things that will make them be noticed. As their ethical responsibility, they are mandated to work for the patient and their wellbeing. By giving out rewards, they begin to feel that these privileges come because of attending to the patient. This can then go both ways.
I would recommend exercising authority, despite its weaknesses. It possesses powerful strength, if used in the right way, may lead to fruitful results. I recommend it because it leads to positive outcomes, as the employees can follow instructions, abide by the rules, and meet the standards that have been set by the manager. It is also easy to adjust the approach that the manager takes, once it is realized that they are too lenient on the employees or too harsh on them. Also, with exercising authority, comes respect. The employees learn to respect the manager, and this fosters a positive working relationship and a trustworthy one, as employees can confide in the manager about their concerns and requests, openly.
To implement the strategy, I would first develop the standards of service delivery that all health professionals are supposed to abide. This will ensure that patients receive the best quality of care that will provide positive health outcomes. This step will dictate how health professionals are supposed to care for their patients and the practices that they are supposed to embrace, to achieve this goal.
The next step would be to come up with rules and sanctions that are to be implemented to ensure that employees work within their job descriptions and work to provide quality services to the patient. The rules will be concerning the practices of each professional. For example, nurses and physicians will have different rules and regulations that will govern their actions. If broken, warnings will then be given to the employee. These warnings are for the benefit of the employee as it will ensure that they embrace and act accordingly as they will have a chance to correct their wrongs. If the rule is broken once more, then an appropriate sanction or probationary period is given to the employee where they will be seated down and talked to by the relevant personnel. If this behavior goes on, then the contract and employment will be terminated, and the employee will have to leave the facility.
The next step will be to exercise these rules and regulations and see how the employees react to them. They will be tested, and if successful, they will be finalized and implemented. This testing period will enable the manager to gather the responses of the employees and gauge the acceptance or denial of the set standard and rules. If the testing period is successful, then the rules will be applied and be effective immediately. The final step is to evaluate whether the rules are being followed. This will be done through routine checks and random pop-ups. This will enable all employees to stay on track by practicing the set rules and maintaining the authority figure.
To measure whether the intended change is occurring, I will carry out a survey where I will be able to receive feedback. This survey will be in the form of questionnaires, personal interviews, and a small meeting in the departments. The questionnaires will pose questions that the employee will fill out. This will be an anonymous questionnaire to enable the employee to be as open as possible concerning the changes that are underway. Interviews will also be carried out to evaluate whether the standards, rules, and regulations are practical and the challenges that one faces in abiding by these standards or rues. The small meetings that are to be held will be once every two weeks, to ensure one is kept up to date concerning the matters that are likely to arise. This will be an open forum, where employees can ask questions and seek clarification for some of the issues.
A challenge that is likely to occur once the strategy is initiated is that of monotony. As the manager, one may get tired or feel the monotony of carrying out routine checks and therefore, slack off in carrying out this task. Initially, there will be a need to ensure that all parties are compliant with the changes, and therefore, routine checks will be compulsory. However, when everybody has become accustomed to these standards and rules, they eventually fall in line and do the necessary tasks that are required of them. This becomes a common habit, and everybody is aware of what is expected of him or her. There is a high chance that routine checks will become fewer and fewer over time. This then leads to laxity and therefore, less authority.
An approach to overcome this would be to come up with different ways of carrying out the routine checks. If one is used to carrying them out during the weekdays, it should be switched to doing them on weekends. Changing the routine will enable one to continue carrying out this process. Also, appointing leaders within the various department will make this process more monotonous. A leader will ensure that these standards are adhered to, and the manager will only have to come in for the routine checks when the need arises.
Business Enterprise Mapping (2017). 5 Effective Change Management Strategies. Retrieved from https://www.businessmapping.com/blog/5-effective-change-management-strategies/
Saint Joseph’s University (2011). Health Care Reform: Duties and Responsibilities of the Stakeholders. Retrieved from https://sites.sju.edu/icb/health-care-reform-duties-and- responsibilities-of-the-stakeholders/
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